Association of Preoperative Hyponatremia With Surgical Outcomes: A Systematic Review and Meta-analysis of 32 Observational Studies
Pooled result · Major complications (composite of 9 major complications)Result — go to the resultAdjusted odds ratio 1.37 95% CI 1.23–1.53Authors' conclusion
Our meta-analysis suggests that preoperative hyponatremia is associated with poorer early mortality and major morbidity outcomes in surgical patients. Hyponatremia is also a specific prognosticator for major complications in surgical patients, reiterating its potential use as a clinical indicator of poor outcomes.
Study context
- Population
- Adults aged ≥18 years undergoing surgery; Medline (PubMed), Embase, Cochrane Library through July 2, 2021
- Participants
- 1,301,346 adults32 observational studies
- Comparison
- Preoperative hyponatremia vs normal sodium concentrations
- Outcome
- Major complications (composite of 9 major complications)
Methodological detailsAll studies had low risk of bias
- All studies had low risk of bias
Pooled result
As reported in the abstract
Adjusted odds ratio
1.37
95% CI 1.23–1.53
Hyponatremiavs Normonatremia
aOR 1.37 (95% CI 1.23–1.53)
Further pooled results
| Outcome | aHR (95% CI) | |
|---|---|---|
| Early mortality (<90 days)I2 = 97%; N = 10 · adjusted for covariates | 1.27 (1.13–1.43) | |
| 0.512Adjusted hazard ratio (log scale) |
- Prognostic performance of preoperative hyponatremia for major complications
- 0.70 · AUC · negative likelihood ratio 0.90 · specificity 88% · sensitivity 25%
Respiratory, renal and septic complications
- Preoperative hyponatremia had significant associations with respiratory, renal and septic complications
Original publication
Association of Preoperative Hyponatremia With Surgical Outcomes: A Systematic Review and Meta-analysis of 32 Observational Studies. J Clin Endocrinol Metab. Published 6 December 2022. doi:10.
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